Doctor of Philosophy, The Ohio State University, 2024, Educational Studies

Each year in the United States, an estimated 57.8 million adults and 7.7 million children experience mental health issues with far-reaching implications (National Alliance on Mental Illness [NAMI], 2023). Despite our increased awareness in the aftermath of the COVID-19 pandemic, which both exposed and exacerbated the problem, access to services remains severely limited for 163 million Americans living in Mental Health Professional Shortage Areas (NAMI, 2023). There is an insufficient supply of mental health providers in America, and an additional 8,251 practitioners are needed immediately to adequately meet the needs of the people (Health Resource & Services Administration [HRSA], 2023b). However, this deficit will not be resolved soon, as nearly half of mental health practitioners currently report intentions to leave their employment (Centers for Disease Control [CDC], 2023). Furthermore, resolving the shortage will require more than hiring additional mental health professionals (HRSA, 2023b). Compared to the larger workforce, mental health providers have a higher risk of experiencing detrimental occupational outcomes (Cocker & Joss, 2016; Ledoux, 2015; Ondrejkova & Halamova, 2022; Sinclair et al., 2017; Sorenson et al., 2016). Burnout, one of the occupational harms associated with the unique demands of care work, is a driving force in the provider retention problem (CDC, 2023; Hoge et al., 2007; Morse et al., 2012). Although there is a direct link between burnout and a lack of organizational support (Schaufeli & Greenglass, 2001), there is a lack of research examining systemic causal factors. Most existing studies neglect to explore links between work characteristics and employee well-being and are restricted to investigating individual traits as contributors (CDC, 2023). The present study confronts the gap in the literature through a systemic exploratory analysis. This quantitative study examined the link between workplace environments and mental health (open full item for complete abstract)

Committee: Darcy Haag Granello (Committee Chair); Paul Granello (Committee Member); Noelle Arnold (Committee Member) Subjects: Behavioral Sciences; Behaviorial Sciences; Clinical Psychology; Counseling Education; Counseling Psychology; Health Care; Health Care Management; Medical Ethics; Mental Health; Occupational Health; Occupational Psychology; Organization Theory; Organizational Behavior; Psychology; Psychotherapy; Public Health; Public Health Education; Systems Design; Therapy

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

The purpose of this qualitative single site case study was to measure from the perspective of direct service professionals how well clients with Intellectual and Developmental Disabilities (IDD) are being socially included in the community. The research question pursued was the following: How does the Direct Service Professional's (DSP) measurement of successful inclusion in the community impact clients with IDD living in supportive living homes? A literature review of social inclusion and quality of life for individuals with intellectual and developmental disabilities indicates the focus of studies has been on the family members who are a natural support to the clients. Limited research exists on the perspective or measurement of Direct Support Professionals who are closest to the clients in many cases and provide support and care. Primary data for this qualitative study was from semi–structured, open–ended interviews with 11 (DSPs) at a single site agency. The primary goal of this research is to determine from the lens of DSP staff if clients are being successfully socially included in the community.

Committee: Alyncia Bowen (Committee Chair); Gail Frankle (Committee Member); Eliot Jackson (Committee Member) Subjects: Behaviorial Sciences; Health Care; Social Research

Psy. D., Antioch University, 2023, Antioch Seattle: Clinical Psychology

This quantitative study explores the relationships among trait mindfulness, self-compassion, and compassion fatigue (CF) in mental health professionals working with clients with a terminal illness. The Five-Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale, and Quality of Life Version 5 were used to explore these facets through linear multiple regression analysis. The Reactions to Research Participation Questionnaire–Revised was used to explore the cost–benefit ratio based on participant perceptions of the research experience. Participants (N = 43) self-selected from emailed invitations sent to members of professional organizations. Data was analyzed using multiple linear regression. Significant correlations included individual relationships between elevated trait mindfulness levels, self-compassion levels, percentage of session content focused on a client's terminal illness, and FFMQ nonjudge subscale scores with lower CF levels. Additional outcomes also identified significant support for a correlation between higher FFMQ observe subscale scores with higher CF levels, and a moderating effect from gender in the correlation between trait mindfulness and CF levels. Generally, participants reported perceived benefits outweighed perceived costs of contributing to this project. Results warrant additional research to explore significant findings and potential intervention strategies for bolstering trait mindfulness and self-compassion levels among mental health professionals working with clients with a terminal illness.

Committee: Christopher Heffner (Committee Chair); Alejandra Suárez (Committee Member); William Heusler (Committee Member) Subjects: Mental Health; Psychology

Bachelor of Science, Walsh University, 2022, Honors

The work of forensic nursing requires its nurses to display large amounts of compassion and empathy for their patients, who are victims of violent crimes. The forensic nurse's personal mental health and well-being can be negatively impacted by the extraneous use of empathy and compassion. Multiple gaps within the research were identified when detailing the specifics of both the positive and negative effects the role of forensic nursing has on its nurses' mental well-being. A mixed methods research approach was conducted to investigate the prevalence and impact of compassion fatigue/burnout, secondary traumatic stress, and compassion satisfaction amongst forensic nurses. A survey of practicing forensic nurses within the United States, recruited from the International Association of Forensic Nurses, was conducted to collect both qualitative and quantitative data. The survey consisted of basic screening/inclusion criteria questions, demographic information, the Professional Quality of Life questionnaire created by Dr. Beth Stamm, and five short extended response questions. nu

Committee: Mary Cook (Advisor); Nina Rytwinski (Committee Co-Chair); Jennifer Clevinger (Committee Co-Chair); Tammie Davis (Other) Subjects: Nursing

Doctor of Philosophy (PhD), Ohio University, 2022, Higher Education (Education)

This study explored the Professional Quality of Life in behavioral intervention team members at community colleges through the subcategories of compassion satisfaction and compassion fatigue. Although major tragedies are rare at colleges and universities, the emotional toll that behavioral intervention team members experience through listening to student stories and creating appropriate interventions can be taxing on their Professional Quality of Life. Stamm (2010) founded the Professional Quality of Life scale which measures how those in helping professions experience compassion satisfaction and compassion fatigue through the work they do. Student affairs professionals have not commonly been studied regarding compassion satisfaction and compassion fatigue, and this study aimed to navigate these experiences in behavioral intervention members. There were a variety of themes that came from this qualitative study. The first theme was that behavioral intervention members found their work challenging, but very rewarding. Most of the participants found that graduation was the ultimate celebration because it meant that the interventions for the students had successfully led to completion of their degree. Another theme is that support from fellow team members, as well as friends and family was important to the members keeping a positive Professional Quality of Life. Participants also shared that working for community colleges has allowed them to keep a good work-life balance. Another theme is that participants were growing professionally which helped their professional quality of life. There was also a common theme of the fear of missing important information that would impact a student's behavior that could possibly lead to tragedy. Implications for this study include preparing new student affairs professionals for working in community colleges, as the experience can be vastly different than that of four-year institutions. Preparing student affairs professionals in h (open full item for complete abstract)

Committee: Laura Harrison (Committee Chair) Subjects: Education; Higher Education

Doctor of Philosophy, University of Akron, 2021, Marriage and Family Counseling/Therapy

The purpose of the current study was to explore the relationship between professional quality of life and self-care among marriage and family therapists (MFT's) within two-years post-graduation. The effects of COVID-19 on the clinical population of early career MFT's were also examined. A sample of 101 MFT's were surveyed through emails and social media to obtain data for testing the research question and hypotheses by completing The Professional Quality of Life Scale (ProQOL), the Self-Care Assessment Worksheet (SCAW), and the EPII Brief Supplemental Mental Provider Module (EPII SMHP Brief), along with a demographic questionnaire. Utilizing the frameworks of General Systems Theory and Saakvitne and Pearlman's (1996) Model of Self Care, the present study conducted a canonical correlation analysis to examine the relationships between the three predictor variables of the ProQOL and the six criterion variables of the SCAW. The present study hypothesized that there would be statistically significant relationship between measures of perceived professional quality (predictor variables) and self-care (criterion variables) as multioperationalized between the variable sets. A statistically significant relationship was present between both measures indicating support for the hypothesis. Results contribute new evidence to field of marriage and family therapy in that not engaging in self-care can negatively affect one's level of compassion satisfaction and can increase both burnout and compassion fatigue/secondary traumatic stress among early career MFT's. These findings could help not only clinicians, but also supervisors, educators, and policy makers in better understanding the relationship between professional quality of life and self-care. In exploring the effects of COVID-19, the present study found that the pandemic has had a great impact on the clinical population early career MFT's. These results show that more investigation is needed to explore these impacts, as well a (open full item for complete abstract)

Committee: Rikki Patton (Advisor); Ingrid Weigold (Committee Member); Rikki Patton (Committee Chair); David Tefteller (Committee Member); Wondimu Ahmed (Committee Member); Heather Katafiasz (Committee Member) Subjects: Counseling Education; Mental Health

DNP, Otterbein University, 2021, Nursing

Background/Significance: Significant barriers to forensic nurse workforce development exist, affecting patient access to care. Retention of forensic nurses is a persistent problem. Turn-over of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS). Methods: A convenience sample of forensic nurse program coordinators was used to identify the effect of an educational session on professional quality of life and strategies for reducing stressors within the role on ProQOL-5 and TIS-6 scores using a pre- post-test quasi-experimental survey design. Correlation between professional quality of life indicators and turnover intention was explored. Results: Thirty-eight forensic nurse coordinators completed initial administration and eight participants completed follow up. Cohort (n= 38) pre-intervention CS levels were average to high (x = 41.42), BO average to low (x = 22.53), and STS levels average to low (x = 22.89). Statistically significant positive correlations were noted between each ProQOL-5 subscale and turnover intention (CS r = 0.59, p Conclusions: Increased awareness of the impact of CS, BO and STS could decrease the impact on forensic nurses and reduce turnover. Recommendations: Strategies to reduce BO and STS in forensic nurses have the potential to decrease turnover in the role and enhance professional quality

Committee: Jacqueline Haverkamp DNP, MBA, APRN, FNP-C (Advisor); Ruth Downing MSN, RN, CNP, SANE-A (Committee Member) Subjects: Health Sciences; Medicine; Nursing

Doctor of Philosophy (PhD), Ohio University, 2021, Higher Education (Education)

Compassion satisfaction and compassion fatigue are best described as the good stuff and the bad stuff that comes from our emotional engagement with those who are suffering (Stamm, 2010). The literature on compassion satisfaction and compassion fatigue in higher education is minimal and limited to studies pertaining student affairs practitioners and nursing educators (Bernstein-Chernoff, 2016; Gardner, 2015; Hoy & Ngyuen, 2020, Raimondi, 2019; Stoves, 2014). This is problematic because the consequences of compassion fatigue and the benefits of compassion satisfaction are minimally understood while the client population, students, continues to exhibit increased and sustained mental wellbeing struggles (ACHANCHA, 2017; Eisenberg et al., 2007). This dissertation is a qualitative research study that investigated the ways tenure track faculty members experience compassion fatigue, compassion satisfaction, and the consequences of those experiences because of working with students. Using professional quality of life theory and appreciative inquiry as theoretical frameworks, this research found that students were a driving force of compassion satisfaction and that the faculty work environments are strong sources of burnout. Implications based on these findings were discussed to address the nature of the faculty work experience both to leverage the positive attributes from working with students and the negative aspects of the faculty work context.

Committee: Laura Harrison (Committee Chair) Subjects: Higher Education

DNP, Kent State University, 2021, College of Nursing

Background: Healthcare providers in highly stressful environments experience the effects of workplace stress, burnout, compassion fatigue, and secondary traumatic stress due to several work-related factors. Among them, ethical issues, high emotional burden, institutional and patient/family demands are commonly experienced stressors. These experiences can be characterized by emotional exhaustion, depersonalization, and diminished personal accomplishment related to poor professional quality of life and lack of self-care. Prolonged, these characteristics may result in unsatisfactory quality outcomes and patient safety events. The COVID-19 pandemic has introduced new challenges in providing healthcare to the critically ill and additional pressures on the professional quality of life of advanced practice providers (APPs). Resources are needed to support APPs in navigating the many stressors experienced and maintain a satisfactory professional quality of life. Mindfulness based interventions have been used to promote self-care abilities to improve professional well-being and work life-balance in many professions including healthcare. Mobile mindfulness applications are available and can allow mindfulness practices to be easily accessed and integrated into daily practice. Methods: A quality improvement approach was utilized to implement and evaluate a mobile mindfulness-based application. Thirty-seven APPs were recruited from a large urban medical center, within 8 different ICU specialties, during the second wave of the COVID -19 outbreak in October 2020 through -January 2021. All participants were asked to practice a 10 minute daily mindfulness-based intervention via a mobile application (Headspace) for 30 days. A quasi-experimental pre-and post-test design was used to measure professional quality of life and mindfulness before and after the intervention. Objectives: To determine the portability and efficacy of a mobile mindfulness application to improve provider comp (open full item for complete abstract)

Committee: Amy Petrinec PhD (Committee Chair); Marilyn Nibling DNP (Committee Member); Pam Stephenson PhD (Committee Member); Cindy Byrd DNP (Advisor) Subjects: Health Care; Health Care Management; Nursing

Doctor of Philosophy (PhD), Ohio University, 2016, Counselor Education (Education)

Research shows that stress in the workplace can contribute to negative physical and mental health outcomes among workers in a variety of settings, while the personality disposition of Hardiness can serve as a protective factor against those outcomes. Existing literature on human services professionals shows that Perceived Work Stress and Hardiness can predict Professional Quality of Life, which includes the positive outcome of Compassion Satisfaction and the negative outcomes of Burnout and Secondary Traumatic Stress (Stamm, 2010). The purpose of the current study was to determine whether Perceived Work Stress and the Hardiness components of Control, Commitment, and Challenge predict Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Emergency Services and Assessment (ES) clinicians in the Commonwealth of Virginia. ES clinicians conduct prescreening assessments for involuntary psychiatric hospitalizations and are exposed to unique work stressors. A secondary aim of the current study was to determine if there are interactions among the variables that better explain the relationships. Findings indicated that Perceived Work Stress and Hardiness are significant predictors of Professional Quality of Life for ES clinicians, but not all components of Hardiness made significant contributions to each regression model. The Hardiness component of Commitment did not significantly predict Secondary Traumatic Stress. The Hardiness component of Challenge did not significantly predict any of the outcome variables. Perceived Work Stress, Control, and Commitment accounted for 58.3% of the variance in Compassion Satisfaction. Perceived Work Stress, Control, and Commitment accounted for 65.2% of the variance in Burnout. Perceived Work Stress and Control accounted for 31.2% of the variance in Secondary Traumatic Stress. No interaction effects were detected among the predictor variables that better explained the relationships in the regression models for (open full item for complete abstract)

Committee: Christine Bhat (Committee Chair); Yegan Pillay (Committee Member); Tom Davis (Committee Member); Dianne Gut (Committee Member) Subjects: Counseling Education; Counseling Psychology; Occupational Psychology